Category: Appraising Change: The Book


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4.3 Writing a Goal Statement

A is a succinctly written version of your intervention plan used to convey the information essential to describing the treatment target, the intervention procedures and the outcome criteria. Goal statements can be used to address the spectrum of your client’s needs: the acquisition of target behavior in a specific therapy activity of a treatment outcome,

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5.0 Developing Observation-Based Tracking Plans

Case Study:Tracking Dilemmas

Laura and her colleagues are sitting in the library developing their first treatment plans for their clients. Although they have a pretty good idea about their client’s treatment goals, figuring out why, what and how to track remains a challenge:

Laura: Ok, I’ve identified JJ’s speech goals. Now my clinic supervisor said to come up with 5 to 6 different activities and games to help him practice his speech.

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5.1 Basics of Observation-based Tracking

Much of the assessment of client progress and clinical change comes about through behavioral observation. It could be the direct observation of the client’s response elicited during structured therapy, tracking the communicative behaviors produced during social play, recording the duration of vocalization, or making judgements about the client’s communicative performance, success and/or difficulty.  In this section,

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5.2 Direct Behavior Observation: Event Recording

The direct observation of a behavioral event utilize the client’s behavior as the unit of analysis. We are interested in reporting the occurrence of a behavior so that it can be counted and compared to other behaviors, or proportion of occasions that it occurred. Event recording strategies work best for behaviors that are observationally distinct and relatively short in duration,

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5.3 Direct Behavior Observation: Measuring Time & Behavior

All behavior has a durative (i.e., time-based) component. However for many types of therapy, time may not be  important  to measure directly. Indeed, counting the the correct productions of an articulation target or the percent of appropriate responses to questions don’t involve any sort of time-based measurement. Rather, they require direct observation event recording strategies.

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5.99 Epilogue: Observation-Based Tracking Plans

A tracking plan consists of the observation and data collection procedures used to behavioral data to determine whether your client is making progress related to your treatment and functional communication goals. In order provide valid and reliable data for analysis, a tracking plan should be designed to capture and characterize critical clinical changes, be unbiased but sensitive to important behavior changes,

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6.1 Assessing Client Performance: Graphing Basics

Simple Baseline – Treatment (A|B) Graph

When a particular behavior is observed and measured over time, this information is called a data series. Two appear on the above: (1) the and collected on AD’s articulation performance during a therapy task, and (2) a of her articulation performance during classroom activities. within each series are graphed using the same symbols and connected by a line.

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6.2 Measurement Basics: Level, Trend, Variability, Phase Length

To answer Olswang and Bain’s questions, we use to determine whether there is a notable increase or decrease in our client’s therapy performance over time, and/or whether there is a significant difference between (e.g., vs ). Our confidence in making these decisions depends, in part, on the number of data points being evaluated and the variability of the client’s performance within a phase.

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6.4 Assessing Client Performance: Treatment-Only Design (B)

Introduction: Does My Client’s Performance Change Over Time?

Starting therapy without first taking baseline data is often misunderstood, both in terms of its utility, as well as its limitations. To its credit, a Treatment-Only approach may be justified if the client is in crisis or if the client’s condition is well understood and there isn’t much need to collect baseline data.

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6.5 Evaluating Clinical Change: Using a Simple Phase-Change (A|B) Design

Considerations Involving the Simple Phase-Change (A|B) Design

The strategy is comprised of two phases, typically a (A) phase and a (B) phase. The baseline phase serves as a control to compare against the client’s performance when receiving intervention services. In addition, the client may be observed post-treatment to assess stability and generalization. As will be shown below,

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6.6 Designs to Match Treatment Programs and Address Specific Questions

In the previous sections we used the to address relatively straightforward issues about behavior change in response to a single intervention (e.g., is my client improving?, Is he responding to the treatment regime?). The A|B Design can also be modified to address a variety of tracking and evaluation situations commonly dealt with in our day-to-day work with clients.

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